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Thread: Neonatal Critical Care

  1. #1

    Default Neonatal Critical Care

    AAPC: Back to School
    I think I know tha answer but need some affirmation. Here is the scenario:
    A neonatologist admits a neonate 20 days old to critical care 99295 and 99296. The patient stays in the intensive care unit requiring critical care for 10 days. The neonate is now over 28 days old. Do you switch to the critical care code 99294 Subsequent inpatient pediatric critical care for the days spent in NICU for those days 29 and 30? Does this make any sense. I am thinking that the answer would be yes since the patient is over 28 days and no longer meets the criteria for 99296? Can someone figure this message out and help me. Thanks, Lynn Kimsey, CPC-I

  2. #2


    Yes, once the patient is over 28 days old and still requires critical care the code must be switched to 99294.

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